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Updated: Jun 9, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
A prospective case-controlled cohort study of endothelial function in patients with moderate to severe psoriasis
C L Martyn-Simmons1, R R Ranawaka, P Chowienczyk
1St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London, Guy's Hospital, London SE1 9RT, UK.
Insights
Psoriasis patients showed no endothelial dysfunction, suggesting it's not a direct cardiovascular disease risk. However, elevated high-sensitivity C-reactive protein (hsCRP) levels in psoriasis patients may indicate inflammation independent of traditional cardiovascular risk factors.
Area of Science:
- Dermatology
- Cardiology
- Inflammation Research
Background:
- Severe psoriasis is linked to increased cardiovascular disease (CVD) risk.
- This risk may stem from traditional risk factors or be independent of them.
Purpose of the Study:
- To investigate if psoriasis itself is a risk factor for CVD.
- Utilized endothelial dysfunction and high-sensitivity C-reactive protein (hsCRP) as CVD markers.
Main Methods:
- Prospective, case-controlled study of severe psoriasis patients.
- Excluded patients with established CVD or conventional CVD risks.
- Assessed endothelial dysfunction via flow-mediated brachial artery dilatation and measured hsCRP levels.
Main Results:
- No significant difference in endothelial dysfunction between psoriasis patients and controls.
- Significantly elevated hsCRP levels observed in psoriasis patients compared to controls.
- High prevalence of traditional cardiovascular risk factors noted in the psoriasis cohort.
Conclusions:
- Psoriasis alone does not appear to be an independent risk factor for CVD.
- Elevated hsCRP in psoriasis patients may be independent of atheroma risk.
- Severe psoriasis is associated with a high prevalence of traditional cardiovascular risk factors.
Background:
There is well-documented evidence that patients with moderate and severe psoriasis have a significantly increased risk of cardiovascular disease (CVD). While this risk can, at least in part, be attributed to the high prevalence of traditional risk factors in the population with psoriasis, some epidemiological evidence suggests it may be independent of these.
Objectives:
This prospective, case-controlled study investigates whether psoriasis is a risk factor for CVD using two, validated, sensitive markers of CVD, endothelial dysfunction and high-sensitivity C-reactive protein (hsCRP).
Methods:
Patients were recruited from a tertiary referral psoriasis clinic and exclusion criteria included established CVD and/or conventional risks for CVD. Preclinical CVD was assessed using flow-mediated brachial artery dilatation, which measures endothelial dysfunction, and hsCRP, a serological marker of atherosclerosis.
Results:
Sixty-four patients (22%) out of a total of 285 consecutive patients attending the severe psoriasis clinic were entered into the study. One hundred and sixty-one (56%) were excluded following identification of cardiovascular risk; 39 of the 161 (24%) had at least two cardiovascular risk factors. A further 16 (6%) patients were excluded because of established CVD. No statistically significant difference in endothelial dysfunction was observed between patients with psoriasis (n = 60) and healthy controls (n = 117) (P = 0·508). The hsCRP level was, however, significantly elevated in the psoriasis group (2·828 mg L(-1), SEM 0·219; controls 0·728 mg L(-1), SEM 0·142; P < 0·05).
Conclusion:
This large, investigative study is the first to assess endothelial function in patients with psoriasis after exclusion of traditional risk factors for CVD. These data suggest that psoriasis per se is not a risk factor for CVD and that elevated hsCRP is possibly independent of atheroma risk. There was a high prevalence of traditional risk factors in our population with severe psoriasis.
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